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[类风湿关节炎患者循环调节性T细胞与疾病活动的关联]

[Association of circulating Treg cells with disease activity in patients with rheumatoid arthritis].

作者信息

Chen Ruilin, Tao Yi, Qiu Kewei, Huang Wenhui, Huang Chenghui, Li Juan

机构信息

Department of Rheumatology, Southern Medical University, Guangzhou, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2012 Jun;32(6):886-9.

Abstract

OBJECTIVE

To investigate the changes in the circulating levels of Treg cells in patients with rheumatoid arthritis (RA) and their associations with the disease activity.

METHODS

The fraction of circulating CD4+CD25+FOXP3+ Treg cells in 40 active RA patients and 40 healthy controls were determined by flow cytometry. The serum levels of interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were measured using enzyme-linked immunosorbent assay, and the expression of Foxp3 mRNA was detected with real-time PCR. The correlation of the changes in the fraction of Treg cells and the disease activity of RA was analyzed.

RESULTS

RA patients showed a significantly lower level of circulating Treg cells than the control subjects [(5.36∓1.55)% vs (7.49∓1.46)%, P<0.01]. The expression of Foxp3 mRNA (P<0.01) and serum IL-10 level (P=0.000) were significantly lower, whereas TGF-β1 significantly higher (P=0.000) in RA patients than in the controls. Spearman analysis showed that serum level of IL-10 but not TGF-β1 was correlated to the fraction of Treg cells and Foxp3 mRNA expression, but the fraction of Treg cells was not correlated to such indices of disease activity as tender joint counts, swollen joint counts, visual analog scale, HAQ, disease activity score in 28 joints, ESR, or CRP, nor to RA self-antibodies (including RF and anti-CCP antibodies).

CONCLUSION

A lower fraction and dysfunction of circulating Treg cells might be involved in the pathologies of RA, and a higher disease activity is associated with a greater reduction of Treg cells.

摘要

目的

探讨类风湿关节炎(RA)患者循环中调节性T细胞(Treg细胞)水平的变化及其与疾病活动度的关系。

方法

采用流式细胞术检测40例活动期RA患者及40例健康对照者循环中CD4+CD25+FOXP3+ Treg细胞的比例。采用酶联免疫吸附测定法检测血清白细胞介素-10(IL-10)和转化生长因子-β1(TGF-β1)水平,并用实时聚合酶链反应检测Foxp3 mRNA的表达。分析Treg细胞比例变化与RA疾病活动度的相关性。

结果

RA患者循环中Treg细胞水平显著低于对照组[(5.36±1.55)% vs(7.49±1.46)%,P<0.01]。与对照组相比,RA患者Foxp3 mRNA表达(P<0.01)和血清IL-10水平(P=0.000)显著降低,而TGF-β1显著升高(P=0.000)。Spearman分析显示,血清IL-10水平而非TGF-β1水平与Treg细胞比例及Foxp3 mRNA表达相关,但Treg细胞比例与压痛关节数、肿胀关节数、视觉模拟评分、健康评估问卷、28个关节疾病活动评分、红细胞沉降率或C反应蛋白等疾病活动指标无关,也与RA自身抗体(包括类风湿因子和抗环瓜氨酸肽抗体)无关。

结论

循环中Treg细胞比例降低及功能障碍可能参与RA的发病机制,疾病活动度越高,Treg细胞减少越明显。

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